"Prevention" programs that promise to save healthcare costs

In his latest article, Dr. Westby G. Fisher, MD, FACC carries the torch for health care that is evidence-based and remembers first, to do no harm. Public health initiatives that talk about preventing diseases may sound convincing, but might most really be little more than political rhetoric, backed by huge monies from companies needing to “get the word out” about their wonder drugs and scanners? We’d all like to believe we can prevent diseases and aging, but it just isn’t so. He calls upon us to stop and ask if these massive preventive health programs actually waste money that could doom our healthcare system.

His article begins:

When It Comes to Prevention: First, Do No Harm

...[D]o "prevention" programs really reduce costs to our health care system? Can people with cancer or heart disease or pneumonia or multiple sclerosis “prevent” their disease? Can people “prevent” getting older? Can all accidents be “prevented?” How about arthritis or diabetes? Can we prevent their onset? Can government force people to eat less or stop smoking? Would we want this? Or in the case of the much ballyhooed genetic testing – can people really “prevent” a genetic disease from developing? As a doctor, I’d love to prevent all disease that afflicts man, but I know this is impossible....

But new “prevention” initiatives are underway by healthcare insurers who “reward” (bribe?) their policy members with financial incentives to participate in weight reduction classes and to stop smoking. We are told this will keep costs down. But the overall benefit to reducing costs to our healthcare system has not been clearly demonstrated. On the contrary...

What is clear is that programs and tests to perform “prevention” are consuming huge health care dollars – from advertising, marketing, frequent doctor visits, early CT scans, carotid ultrasounds, lipid monitoring, mammography, colonoscopy, genetic testing – all of these are expensive (and becoming more so). Just diagnosing something earlier – does that save healthcare costs or increase them overall? Early diagnosis might prevent later complications of disease, to be sure. But it might also increase the contact with the healthcare system and extend expensive treatments. Early diagnosis also provides a convenient means for insurers to deny a patient coverage if they change jobs. This might save the insurers costs, but the patient? ....

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